在胃癌手术中使用的手术内麻醉方法与长期死亡率之间的关联:使用日本索赔数据库的回顾性观察研究
Tomoko Kagawa1,2, Kiyoyasu Kurahashi3, Tomotsugu Seki1,4
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Journal of anesthesia
|December 15, 2023
概括
这项研究发现,在接受吸入麻醉剂和接受静脉麻醉剂的患者之间,胃癌胃切除术后的整体存活率没有显著差异. 麻醉类型的选择对这一组患者的长期死亡风险没有影响.
科学领域:
- 麻醉学 麻醉学
- 手术瘤学手术瘤学
- 临床流行病学临床流行病学
背景情况:
- 麻醉剂与患者预后之间的关联是有争议的.
- 以前的研究表明,关于吸入与静脉内麻醉的结果存在矛盾.
研究的目的:
- 调查麻醉类型 (吸入 vs 静脉注射) 是否会影响经过胃切除术的胃癌患者的全因死亡风险.
- 为了根据麻醉剂的管理来比较术后生存结果.
主要方法:
- 对日本全国范围的保险索赔数据库 (2005-2019) 的分析.
- 包括在全身麻醉下进行胃切除术的胃癌患者.
- 使用多变量Cox比例危险模型,比较吸入 (Sevoflurane,Isoflurane,Desflurane) 和静脉注射 (propofol) 麻醉组之间的整体存活率.
主要成果:
- 分析了2671名符合条件的患者,2105人接受了吸入,566人接受了静脉注射麻醉剂.
- 随访时间中位数为795天.
- 在吸入和静脉麻醉组之间没有观察到总生存时间的显著差异 (HR 0.97,95% CI 0.56-1.70,P=0.93).
结论:
- 吸入和静脉注射麻醉在经过胃切除术的胃癌患者中显示出类似的术后整体生存风险.
- 麻醉剂类型似乎不是这个人群中长期死亡率的重要决定因素.
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